Current research in the pathogenesis of aseptic implant loosening associated with particulate wear debris.
Current research in the pathogenesis of aseptic implant loosening associated with particulate wear debris.
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发表时间：
2013-02
影响因子：
0.4
通讯作者：
Yunpeng Jiang;T. Jia;P. Wooley;Shang-You Yang
中科院分区：
文献类型：
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作者：
Yunpeng Jiang;T. Jia;P. Wooley;Shang-You Yang
假体周围骨溶解是全关节置换术最常见的长期并发症，通常会导致植入物无菌性松动，这种情况发生在高达 34% 的年轻植入物接受者中，通常需要进行手术修复。轴承表面的关节运动不断产生的颗粒磨损碎片被认为是假体周围骨质流失和种植体松动的主要原因之一。随着植入物和轴承表面设计的发展，形成了具有特定化学性质、尺寸和形状的各种类型的磨损颗粒，这可能引发不同的免疫或炎症反应。磨损碎片会导致种植体与周围骨之间界面处一系列细胞类型（如巨噬细胞、破骨细胞前体细胞、成骨细胞、淋巴细胞、成纤维细胞等）中各种促炎细胞因子和趋化因子的下调或上调。同时，这些介质通过不同的信号传导机制进一步影响细胞的功能 自分泌或旁分泌方式。本综述总结了磨损碎片如何导致骨溶解的当前概念，并描述了磨损碎片对参与骨溶解的原代细胞类型功能的相互作用和影响。
Periprosthetic osteolysis is the most common long-term complication of a total joint arthroplasty, often resulting in aseptic loosening of the implant, which occurs in up to 34% of younger implant recipients and usually requires surgical revision. Particulate wear debris, continuously generated by articulating motion at the bearing surfaces, has been implicated as one of the primary causes of periprosthetic bone loss and implant loosening. With developing implants and bearing surfaces designs, various types of wear particles with specific chemical nature, dimension and shape are formed, which may initiate different immune or inflammatory responses. Wear debris induces down-regulation or up-regulation of various pro-inflammatory cytokines and chemokines in a range of cell types at the interface between implants and the surrounding bone, such as macrophages, osteoclast precursor cells, osteoblasts, lymphocytes, fibroblasts etc. Concomitantly, these mediators further affect functions of cells through distinct signaling mechanisms in either an autocrine or a paracrine manner. This review summarizes current concepts of how wear debris causes osteolysis, and describes the interaction and effects of wear debris on functions of primary cell types involved in osteolysis.